What is postpartum depression?

Postpartum depression is a serious illness that can happen in the first few months after childbirth. It also can happen after miscarriage or stillbirth. It can make you feel very sad, hopeless, and worthless. You may have trouble caring for and bonding with your baby.

Postpartum depression is not the "baby blues," which usually go away within a couple of weeks. The symptoms of postpartum depression can last for months.

In rare cases, a woman may have a severe form of depression called postpartum psychosis. This is an emergency because it can quickly get worse and put her or others in danger.

It's very important to get treatment for depression. The sooner you get treated, the sooner you'll feel better and enjoy your baby.

The two most common symptoms are:

• Feeling very sad, hopeless, and empty.
• Losing pleasure in everyday things.

Other symptoms include:

• Not feeling hungry, which may cause you to lose weight. (But some people feel more hungry and gain weight.)
• Having trouble sleeping.
• Not being able to concentrate.

Symptoms can occur in the first day or two after the birth. Or they can follow the symptoms of the "baby blues" after a couple of weeks. The symptoms of postpartum depression can last for months.

Postpartum psychosis is rare. Those who have it may feel cut off from their baby. They may see and hear things that aren't there.

Anyone who has postpartum depression can have fleeting thoughts of suicide or of harming their baby. But people who have postpartum psychosis may feel like they have to act on these thoughts.

As part of your postpartum checkup, your doctor will do a physical exam and ask about your moods and emotions. Be sure to tell your doctor about any feelings of "baby blues" at your first checkup after the baby is born. Your doctor will want to follow up with you to see how you are feeling.

Your doctor may check your thyroid-stimulating hormone (TSH) levels. This helps make sure a thyroid problem isn't causing any depression symptoms.

Ask your doctor and family members to watch you closely if you're at higher risk for postpartum depression. For example, you may be at higher risk if:

• You've had depression, depression during pregnancy, or postpartum depression before.
• You've had postpartum psychosis before.
• You have bipolar disorder.

If you have an increased risk for postpartum depression, follow up with your doctor or midwife 1 to 3 weeks after you give birth.

Treatment choices include:

• Counseling. It can give you emotional support and help with problem solving and goal setting. Others in your family may also benefit from counseling.
• Antidepressant medicine. It relieves symptoms for most people.

Doctors recommend that people with moderate to severe postpartum depression combine counseling with medicine. People with mild depression may get better from counseling alone. You can still breastfeed while taking certain antidepressants.

Antidepressants are typically used for 6 months or longer. They're taken first to treat postpartum depression and then to prevent symptoms from coming back.

Getting regular exercise, eating well, and getting enough sleep may also help you feel better. Support from family, friends, or other parents may also help.

Talk to your doctor about your symptoms. Together you can decide what treatment is right for you.

Here are some tips for taking good care of yourself when you have postpartum depression.

• If your doctor prescribed medicine, take it exactly as prescribed.
• Connect with people. Reach out to a friend or loved one. Let someone know how you're doing. Connecting with others can help when you have depression.
• Get as much sunlight as you can. Keep your shades and curtains open. And get outside when you can.
• Eat a healthy diet so you can keep up your energy. And avoid alcohol and caffeine.
• Get daily exercise, such as walks, to help improve your mood.
• Ask for help with preparing food and other daily tasks.
• Get as much rest and sleep as you can. Being too tired can make depression worse.
• Join a support group for new parents. To find one in your area, talk to your doctor.